Active NPI
Big Gym Therapy, LLC
- Pediatric Physical Therapist
- Marietta, GA
National Provider Identifier
1710322706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- Legal business name
- BIG GYM THERAPY, LLC
- Practice address
- 4005 Canton Rd
Marietta, GA 30066-2739 - Phone
- (770) 728-8833
- Fax
- (678) 668-7469
- NPI assigned
- May 3, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Renee Robertson Maddux, P.T.
- Title
- Member
- Phone
- (678) 736-0724
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | |||
| Pediatric Physical Therapist | 2251P0200X | Primary | ||
| Occupational Therapist | 225X00000X | |||
| Pediatric Occupational Therapist | 225XP0200X |
Addresses
Primary practice location
4005 Canton Rd
Marietta, GA 30066-2739
Mailing address
4005 Canton Rd
Marietta, GA 30066-2739
Phone (770) 728-8833
National Provider Directory
National Provider DirectoryLocations
4005 Canton Rd
Marietta, GA 30066
Phone (770) 728-8833
10495 Woodstock Rd
Roswell, GA 30075
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatric Physical Therapist
- Marietta, GA
- NPI 1063572808
-
- Pediatric Physical Therapist
- Marietta, GA
- NPI 1861551640
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367539200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1753228800000",
"number": "1710322706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4005 CANTON RD",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300662739",
"telephone_number": "770-728-8833",
"fax_number": "678-668-7469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4005 CANTON RD",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300662739",
"telephone_number": "770-728-8833",
"fax_number": "678-668-7469"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BIG GYM THERAPY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-05-03",
"last_updated": "2025-07-23",
"certification_date": "2025-07-23",
"status": "A",
"authorized_official_last_name": "MADDUX",
"authorized_official_first_name": "RENEE",
"authorized_official_middle_name": "ROBERTSON",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "678-736-0724",
"authorized_official_credential": "P.T."
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist, Pediatrics",
"state": null,
"license": null,
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist, Pediatrics",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.